Statement of Purpose Despite graduated driver licensing laws (GDL), novice driver crashes remain high in the US. This is a significant, yet preventable, public health problem. Indeed, not all states mandate driver education for novices, and only 15 states include professional behind-the-wheel (BTW) driver training. Furthermore, these programs are only mandated for drivers under age 18. In Ohio, where driver education including BTW training (plus GDL) is required for license applicants <18 years, we conducted a large population-based, prospective study to examine differences in licensing examination and crash outcomes for drivers <18 versus 18–24 years, who are exempt.

Methods/Approach State-wide licensing data in Ohio from 2018 were linked with subsequent police-reported crash records. The sample included N= 136,643 first-time license applicants aged 16–24, of which N= 129,897 received a license. First licensing examination outcome (pass/fail) and first police-reported crash in the initial 2- and 12-months post-licensure (3,789 and 16,215 crashes respectively) were profiled by age, sex, time in learner permit, and tract-level sociodemographics. Regression models assessed the association between age at licensure and crash outcomes, while controlling for covariates.

Results License applicants age 18 were up to 73% more likely to fail their first license examination, and up to 54% and 31% more likely to have a first crash in the first 2- and 12-months post-licensure (respectively) when compared to license applicants age 16. The relationship between age and crash outcomes remained when controlling for time in learner permit and tract-level SES.

Conclusion In Ohio, drivers licensed at age 18 were at highest risk for crashes post-licensure, and 16 year-olds were among the lowest risk age groups.

Significance Ohio’s driver license policies may offer protection against crashes for the most at-risk new drivers, a finding that should be tested in a randomized trial.